Antidepressants During Pregnancy Not Be as Big a Risk to Unborn as Previously Thought: Study

Once researchers calculated for other factors, such as health conditions, they found that the risks of developmental problems linked to antidepressants disappeared.

Although prior research has raised concerns about the potential side effects of antidepressants during pregnancy, new research suggests exposure to the medications before birth does not appear to impact the risk of future learning disorders and developmental disorders among unborn children later in life.

Children born to women who used antidepressants like Zoloft or Paxil during pregnancy did not experience greater rates of neurodevelopment problems, cognitive problems or behavioral issues, according to the findings of a new study published this month in the medical journal JAMA Internal Medicine.

Researchers from Brigham and Women’s Hospital and Harvard Medical School used healthcare utilization data and separated it into cohorts of publicly and privately insured pregnant individuals and their children, using data from the Medicaid Analytic eXtract (MAX) and the IBM MarketScan Research Database.

The data included 1.9 million pregnancies in MAX and 1.25 million pregnancies in MarketScan. Children were followed from birth until outcome diagnosis, disenrollment, death, or until the end of the study; for a maximum 14 years. The study included 145,702 antidepressant-exposed pregnancies compared to more than 3 million unexposed pregnancies.

While data initially indicated children born to women who took antidepressants faced double the risk of neurodevelopmental outcomes, once researchers adjusted for other factors, like health conditions and environmental toxin exposures, they could find no increased risk.

Antidepressant use during pregnancy was not associated with increased risk of autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), specific learning disorders, developmental speech/language disorders, developmental coordination disorders, intellectual disabilities or behavioral disorders, the researchers concluded.

Researchers are optimistic about the study findings, because of the large study size and focused study design. Older studies were largely observational, and did not account for contributing factors like other health conditions, environmental toxins, maternal stress and inflammation, the researchers noted.

Older Studies Raised Antidepressant Pregnancy Risks

Prior research has had conflicting results on the effects of antidepressant use during pregnancy. One study published last year linked antidepressant use during pregnancy to an increased risk of lower test scores for children. That study indicated children born to mothers taking medications like Zoloft or Paxil faced an increased risk of learning disabilities.

Other research indicated using antidepressants like Celexa or Zoloft could increase the child’s risk of being diagnosed with a psychiatric disorder later in life. Disorders included depression, autism, mood disorders and behavioral and emotional disorders.

A 2019 study linked antidepressant use during pregnancy to a 50% increased risk of gestational diabetes, which can lead to serious complications for both the mother and child.

Women are often concerned about antidepressant use during pregnancy, but can receive conflicting opinions from healthcare providers. Some women may stop using antidepressants when they become pregnant for fear of side effects to the child. This can lead to negative mental health side effects. Not treating depression during pregnancy can lead to serious outcomes such as stillbirth, preterm birth, growth restriction and birthweight issues.

A few antidepressants have been linked to birth defects when taking the medications during pregnancy. Women should talk to their doctor about the risk and the benefits of continuing to take antidepressants while pregnant.

“The results of this cohort study suggest that antidepressant use in pregnancy itself does not increase the risk of neurodevelopmental disorders in children,” the researchers determined. “However, given strong crude associations, antidepressant exposure in pregnancy may be an important marker for the need of early screening and intervention.”